Substance use refers to the use of alcohol or drugs, including substances like nicotine, caffeine, prescription drugs, and illegal drugs. Substances make us see, think, feel and behave differently than we usually do.

Substances can be classified as:

• legal (For example: caffeine, sugar, over-the-counter drugs like Tylenol 1 [opioid])
• legal but regulated (For example: nicotine, alcohol, cannabis, prescription drugs like Tylenol 3 [opioid])
  • (Note: Most of the substances listed above are illegal for youth under 18-19 years old in BC)
• illegal (For example: heroin [opioid], cocaine, ecstasy)

Types of substances:

• opioids - such as heroin, fentanyl or prescription drugs such as Oxycontin
• cannabis - also called pot or weed
• depressants - also called downers (alcohol, Xanax, Valium, barbiturates)
• stimulants - also called uppers (cocaine, speed, nicotine)
• hallucinogens - also called psychedelics (magic mushrooms and LSD [acid])

The effect any substance can have on a person depends on:

• the type of substance (For example: depressants, stimulants)
• individual factors (For example: age, past experience, genes)
• the context (For example: how much, how often, other drug use)
• why they are using the substance (see below for more information)

Why do youth use substances?

People have used substances for thousands of years and for many different reasons, including those in this graphic:

^{Adapted from: https://www.heretohelp.bc.ca/infosheet/understanding-substance-use-a-health-promotion-perspective}

Substance use is a complicated behaviour. It's important to consider everything that may influence a youth’s choice to use substances. These factors may include:

• Social Disconnection. Youth may use substances if they don’t feel attached to family, school and community. Feeling connected can strongly protect and help to lower the chance of a youth using substances in problematic ways.
• Existing Conditions. Some youth are more likely to take risks than others, because they have low impulse control, high sensation seeking or conditions like bipolar disorder or fetal alcohol spectrum disorder (FASD).
• Mental Health and Coping. Some youth start to use substances to help them cope with stress, anxiety or depression. Youth who are dealing with complex trauma or emotions may turn to substances. There may be conflict at home, school or among their peers. Using substances may be a form of relief or escape. Sometimes early substance use is linked to eating disorders. Youth may begin using substances such as nicotine because they think it will lower their appetite or control their weight.
• Discrimination. Youth may use substances to deal with stress and unfair treatment because of factors including:
  • race
  • sexual orientation
  • gender identity
  • cultural identity
  • age

As a result, they may be experiencing low self-esteem, shame or guilt. They might be worried about being left out or discriminated against. They may feel invisible, unheard and powerless.

• Self-medicating. Youth may use substances to self-medicate as a way to deal with physical and emotional pain. It may help to dull emotional pain or make the condition seem more manageable, but the effect is only temporary.             
• Social Influences. Youth are exposed to many different influences every day. Some influences may make substance use look cool and fun and with little consequence. From friends and peers to technology and social media - there are many opportunities for youth to learn about or witness substance use. Your child may become curious about substances, want to fit in or feel pressure to use substances.

How substance use can become a problem

It is normal for youth to experiment, but substance use can become a problem if it starts to interfere with daily life and mental health. It’s important to recognize the different stages of substance use and pay attention to your child’s mental health.

These are the stages of substance use:

If someone has a substance use problem and a mental illness at the same time, they have what’s called a concurrent disorder - one example is experiencing both depression and alcohol dependence. You can listen to our podcast episode on concurrent disorders here.

There are signs that a youth may be using substances. The signs and patterns may be more obvious if they are using substances in a problematic way. Be curious if you notice any of these signs, but remember that they could suggest something other than substance use. Here are some of the signs:

Behaviour Signs

• change in overall attitude or personality for no known reason
• loss of motivation, energy, self-esteem, "I don't care" attitude
• unsafe driving or car accidents as a form of self-destruction or driving while impaired
• attending school less, doing less homework, lower grades
• extreme need for privacy, doesn't want to talk about new friends, suspicious behaviour

Physical Signs

• change in personal grooming, sleep pattern, or habits at home 
• smell of substance on breath, body or clothes
• change in appetite or eating habits, unexplained weight loss or gain
• slow or staggering walk, poor coordination, shaking 
• red, watery eyes, pupils larger or smaller than usual, blank stare

Patterns that may suggest problematic substance use:

• using daily
• using before or during work or school
• using as a main way to have fun or relax
• using to deal with negative moods
• using at times of high emotions, such as anger or aggression

Below, you’ll find tips for talking about substance use with your child. There are different approaches depending on if and how much your child is using substances. There are also ideas about what to do if your child comes home under the influence of substances.

Talking about substance use with your child

Even if it seems very difficult, try to talk openly about substance use with your child starting at a young age. But it is never too late and there is no single “right” way to have these conversations. You could ask your child questions while having a casual conversation or watching something together. Or talk about someone else’s substance use. You might share your own experiences of substance use.

Some ideas for having substance use conversations with your child:

• Listen without judgement. Be curious and respectful when you talk with your child. This means listening to understand and seeing your child as a person with valid struggles. Avoid being critical when your child describes what they are struggling with, even if it feels like you are putting aside your own beliefs. With empathy and compassion, show that you know they are struggling and that you accept their feelings. It may be difficult, but it is important to build trust and to let your child know that they can come to you for help.
• Work together. If your child is thinking about or using substances, help them look at why and how they came to this decision. Explore other ways to deal with their situation and where they can get support. Let your child know you are raising the issue because you care about them. Offer support and let them know you are ready to help them deal with whatever may be contributing to their substance use. Help them make informed choices but avoid trying to control their behaviours.
• Focus on well-being. Have ongoing talks so your child can express their ideas and feelings, and hear yours. Let your child know that you care about their overall well-being and life goals. This means helping them develop the skills to make wise decisions - to know when to take risks and when to play it safe. Help your child consider what they need for their physical, mental and emotional well-being now and for the future. Talk about their goals and how substance use may affect their plans.
• Be an example. Think about how you make decisions on how to have fun and spend time with friends. What do you do to deal with stress? How does substance use fit in? Be honest about your own struggles. Recognize that, from an early age, your child watches and learns from you. They see how you monitor, limit or turn down chances to use substances. Let them see you cope with stress without using substances. Suggest ways to deal with pressures in life, such as mindfulness, talking to friends, being active, getting into nature and more.
• Be aware and available. Pay attention to what is going on in your child’s life. Notice any sudden changes in things like mood or schoolwork. Your child could be going through a normal stage of development, or it could be a sign of substance use or a mental health challenge. Respect your child’s need for independence, but also be sure they know you are ready to help. Think about how the things that affect you may affect your child. Create an environment where your child will feel safe and supported for these conversations.
• Stick to the facts. Learn about substances so you can talk accurately about their effects. Try to avoid personal bias and negative ideas about people who use substances. Help to educate your child, and yourself, on the facts about substance use. There are myths and misinformation on the internet so it is important to use trustworthy sources like Foundry, Here to Help and Drug Cocktails.
• Learn about trauma. Some youth who have experienced trauma may use substances to cope. You will need to understand the link between trauma and behaviour to help a child process the trauma and recover in a healthy way. It is important to notice any situations your child may find triggering and try to decrease the triggers. When you know that some information about substance use may be triggering, you can approach the topic more carefully.
• Consider their stage of development. As youth move from childhood to adulthood, their brains and bodies go through a lot of change. These changes often affect the youth’s emotions and behaviour. Their focus is often on the ways they relate to others during this time known as ‘adolescence’. If you understand how to engage with your child at each stage of adolescent development it can help you support their well-being. 
• Build their skills. Have honest, thoughtful discussions with your child about issues important to them. This can help them prepare for situations where substances are offered, and be confident in their choices. Help your child develop important life skills, such as:
  • critical thinking
  • decision making
  • stress management
  • having difficult conversations in social settings
  • planning ahead
• Start small and repeat often. Instead of one big conversation, try having short, meaningful talks from time to time. Use the last conversation as a foundation for the next one. This allows both you and your child to slowly build a sense of comfort and trust. Your child learns they can come to you when they have questions or are struggling with anything to do with substance use.
• Learn from mistakes. Life presents many chances to learn, including those times that involve substance use. Your child can learn helpful strategies when you talk about your own experience. And you may also learn more about your child and their ability to manage tricky situations.

Parenting approaches by stage

The way you deal with substance use may depend on the stage your child is at. The table below has suggestions for how to approach each stage.

Connect and engage with your child

For youth to become resilient and reach their full potential, it is important to have a strong connection to their families, caregivers and other trusted adults. Staying connected with your child can affect their actions and help prevent problematic substance use.

Here are some ways to connect and engage with your child:

• Ask your child about hobbies or interests they have or are curious about. Show interest and support for these activities as they could encourage healthy friendships and build your child’s confidence and skills (for example: music, cooking, exercise, community programs).
• Connect with your child by doing things together that you both enjoy (for example: watch a movie, play a board game, go for a bike ride).

Plan ahead

Plan ahead to help you deal better with a stressful situation. Before your child leaves the house, discuss how you expect them to be responsible. Talk about how to reach you if they need help. Make a plan together with your child to keep them safe. This could include agreeing on a code word they can text you if they feel unsafe. Or discuss what to do in an emergency.

If your child comes home drunk or high, try to respond usefully:

• Stay calm. Let everyone get some rest before you have a big discussion.
• Notice their condition to see if they need medical help or are a safety threat to themselves or anyone else in the household. Try to find out what they have been using and how much. That way you can decide if they are in trouble or just need time to sober up.
• The next morning, calmly let your child know that you are aware they came home impaired. Say that you need to have a conversation with them sometime before the end of the day. Set a time to meet that you both agree on. This gives your child time to go away and sort their feelings and ideas (as you likely have been doing most of the night).
• When you meet, first come to an agreement that your child was high or drunk. Ask how they  feel about it.
• Have an open and honest discussion. Find out how they feel about the substance(s) they have tried or are using. If it does not risk shutting down the conversation, gently ask when, how often and with whom they have used substances. Discuss why they use substances or what benefits they are getting out of it. Try to understand their point of view. This will help you create a stronger connection and keep the lines of communication open.
• Talk about your concerns. Explain how you feel and why you are worried about their substance use. Try to stay calm, stick to the facts and focus your concern on their safety and well-being.

While you continue to offer love and support, you may also need to reach out to a health professional, like a doctor or adolescent substance use specialist. If your child is struggling, there are different types of treatment and resources available.

The kind of support a youth needs will depend on many different factors. A doctor or a youth clinic can refer them to services suited to their stage and situation.

• You can get information about treatment and resources in BC by calling the 24-hour BC Alcohol and Drug Information and Referral Service. This service can connect you with counselling for an individual, family, or small group. It is for people of all ages who are directly or indirectly affected by alcohol and other drug use.
•  In the Lower Mainland, the number is: 604-660-9382, or toll-free anywhere in BC: 1-800-663-1441.

You may also search the HealthLinkBC Directory or contact your local health authority for mental health and substance use support in your area.

Looking for more information on this topic? Connect with a family peer support worker at the Kelty Centre to discover additional resources, learn more about support and treatment options, or just to find a listening ear.